NPI Code Detail JSON Logo

1003868449 NPI number — LEE TAN WOLFE MD

NPI Number: 1003868449
Health Care Provider/Practitioner: LEE TAN WOLFE MD

Information about “1003868449” NPI (LEE TAN WOLFE MD) exists in 1003868449 in HTML format HTML  |  1003868449 in plain Text format TXT  |  1003868449 in PDF (Portable Document Format) PDF  |  1003868449 in an XML format XML  formats.

NPI Number : 1003868449 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1003868449",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "WOLFE",
    "FirstName": "LEE",
    "MiddleName": "TAN",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "33 LONO AVE STE 305",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "KAHULUI",
    "MailingAddressStateName": "HI",
    "MailingAddressPostalCode": "96732-1635",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "808-538-3232",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "222 N NEVADA AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "COLORADO SPRINGS",
    "PracticeLocationAddressStateName": "CO",
    "PracticeLocationAddressPostalCode": "80907",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "719-776-5142",
    "PracticeLocationAddressFaxNumber": "719-776-5827",
    "EnumerationDate": "05/16/2006",
    "LastUpdateDate": "01/07/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207L00000X",
          "TaxonomyName": "Anesthesiology Physician",
          "LicenseNumber": "18225",
          "LicenseNumberStateCode": "MS",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207L00000X",
          "TaxonomyName": "Anesthesiology Physician",
          "LicenseNumber": "42241",
          "LicenseNumberStateCode": "CO",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207L00000X",
          "TaxonomyName": "Anesthesiology Physician",
          "LicenseNumber": "01052930A",
          "LicenseNumberStateCode": "IN",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207L00000X",
          "TaxonomyName": "Anesthesiology Physician",
          "LicenseNumber": "A86812",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207L00000X",
          "TaxonomyName": "Anesthesiology Physician",
          "LicenseNumber": "MD-24787",
          "LicenseNumberStateCode": "HI",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.